Synthetic Stimulants - Designer Stimulant Drug Test

Synthetic stimulants are produced in clandestine labs and
sold online or available at smoke shops. Promoted as “bath
salts,” “research chemicals,” or “plant food,” product
labeling attempts to circumvent regulation by suggesting
they are not for human consumption. Additionally, some forms
of designer stimulants may be sold as “legal” MDMA (Legal
X), or sold and veiled as MDMA tablets.

WHAT ARE THE EFFECTS OF SYNTHETIC STIMULANTS?
Young adults in the U.S. and other countries have reportedly
died from using these products. While synthetic stimulants
appear to affect users in ways similar to amphetamines and
cocaine, reports concerning aggression, tachy­cardia,
paranoia and suicide suggest that they may be more acutely
toxic. Long-term effects are unknown, although experts have
stated that cardio­vascular effects can last for days after
ingestion.

Methylenedioxypyrovalerone - MDPV

Methylenedioxypyrovalerone
(MDPV) is a psychoactive drug with stimulant properties
which acts as a norepinephrine-dopamine reuptake inhibitor (NDRI).
Reportedly, it has been sold since around 2008 as a research
chemical. It is also known as Mtv, MDPK, Magic, Super Coke and
Peevee. In 2010 it was reportedly sold as a legal drug
alternative and marketed in the United States as "bath salts" in
gas stations and convenience stores, similar to the marketing
for Spice and
K2 as incense. MDPV was then
going under the street names of Cloud 9, Ivory Wave, Ocean,
Charge Plus, White Lightning, Scarface, Hurricane Charlie, Red
Dove and White Dove.

Pharmacology

MDPV has no
history of FDA approved medical use. Reportedly, it has four
times the potency of methylphenidate (Ritalin, Concerta). MDPV
is the 3,4-methylenedioxy ring-substituted analog of the
compound pyrovalerone, developed in the 1960s, which has been
used for the treatment of chronic fatigue and as an anorectic,
but caused problems of abuse and dependence However, despite its
structural similarity, the effects of MDPV bear little
resemblance to other methylenedioxyphenylalkylamine derivatives
such as 3,4-methylenedioxy-N-methylamphetamine (MDMA),
instead producing purely stimulant effects with no entactogenic
qualities.

Other drugs with a
similar chemical structure include α-pyrrolidinopropiophenone
(α-PPP), 4'-methyl-α-pyrrolidinopropiophenone (MPPP) and
3',4'-methylenedioxy-α-pyrrolidinopropiophenone (MDPPP).

Appearance

The substance
appears as a pure white to light-brown, significantly
hydrophilic crumbly powder with a slight odour. It appears to
darken slightly in colour and take on a potato-tuber-like odor
if exposed to air for any significant length of time. In some of
the first batches that appeared on the research chemical market,
an impurity was identified and said to consist of pyrrolidine,
which could account for its earthy odour when left uncapped. It
has also been observed to rapidly degrade and change properties
when in exposed to air as a free base.

Effects

MDPV acts as a
stimulant and has been reported to have amphetamine-like or
cocaine-type effects. The acute effects may include:

The effects have a
duration of roughly 3 to 4 hours, with after effects such as
tachycardia, hypertension, and mild stimulation lasting from 6
to 8 hours. High doses have been observed to cause intense,
prolonged panic attacks in stimulant-intolerant users, and there
are anecdotal reports of psychosis from sleep withdrawal and
addiction at higher doses or more frequent dosing intervals.
MDPV has been remarked about more than once for its powers as an
aphrodisiac as well as its craving, which is said to rival that
of
methamphetamine. Users often report to feel compelled to
continue re-dosing, but often lose interest in taking it quickly
because of the unpleasant side effects caused by higher doses.

Extended binges on
MDPV have also been reported to produce severe comedown syndrome
similar to that of methamphetamine, characterized by depression,
lethargy, headache, anxiety, postural hypotension
(lightheadedness and weakness of the muscles), and in some cases
severely
bloodshot
eyes, which usually subside within 4 to 8 hours.
Abdominal pain consistent with kidney pain has also been
reported when MDPV is used for extended periods of time. MDPV
may also cause temporary trismus and/or
bruxism.
Side effects are highly dose-dependent. No fatalities have so
far been reported without the combination of other substances.

Legality

In the United
States, MDPV is not a scheduled drug (except in Louisiana), but
it is beginning to appear on the media radar.

MDPV is legal in
Australia.

Mephedrone Drug
Information

Mephedrone,
also known as 4-methylmethcathinone (4-MMC), or
4-methylephedrone, is a synthetic stimulant and entactogen
drug of the amphetamine
and cathinone classes. Slang names include meph, drone, MCAT. It
is reportedly manufactured in China and is chemically similar to
the cathinone compounds found in the khat plant of eastern
Africa. It comes in the form of tablets or a powder, which users
can swallow, snort or inject, producing similar effects to
MDMA,
amphetamines, and
cocaine.

As well as
producing the intended stimulant effects, negative side effects
occur when mephedrone is used, with teeth grinding being the
most common. The metabolism of mephedrone has been studied in
rats and humans, with the metabolites being able to be detected
in urine after usage. Nothing is known about the potential
neurotoxicity of mephedrone, but scientists have suggested
possible dangers associated with its use based on its similarity
to other drugs. Several people have died after consuming
mephedrone, but some deaths that the media attributed to the
drug were later determined to have been caused by other factors.

Mephedrone was
first synthesized in 1929 but did not become widely known until
it was rediscovered in 2003. By 2007 mephedrone was reported to
be available for sale on the internet, by 2008 law enforcement
agencies had become aware of the compound and by 2010 it had
been reported in most of Europe, being particularly prevalent in
the United Kingdom. Mephedrone was first made illegal in Israel
in 2008, followed by Sweden later that year. In 2010 it was made
illegal in many European countries and in December 2010, the EU
ruled it illegal across Europe. In Australia, New Zealand, the
USA and Canada it is considered illegal as an analog of other
illegal drugs and is controlled by laws similar to the Federal
Analog Act.

History

According to the
European Monitoring Centre for Drugs and Drug Addiction, the
synthesis of mephedrone was first reported in 1929 by Saem de
Burnaga Sanchez in the Bulletin de la Société Chimique de
France, under the name "toluyl-alpha-monomethylaminoethylcetone",
but the compound remained an obscure product of academia until
2003, when it was "re-discovered" and publicised by an
underground chemist on The Hive website, working under the
pseudonym "Kinetic." Kinetic posted on the site, "I’ve been
bored over the last couple of days and had a few fun reagents
lying around, so I thought I’d try and make some
1-(4-methylphenyl)-2-methylaminopropanone hydrochloride, or
4-methylmethcathinone." before going on to describe that after
taking it he had a "fantastic sense of well-being that I haven’t
got from any drug before except my beloved Ecstasy." A drug
similar to mephedrone, containing cathinone, was sold legally in
Israel from around 2004, under the name hagigat. When
this was made illegal, the cathinone was modified and the new
products were sold by the neorganics company. The Psychonaut
Research Project, an EU organization that searches the internet
for information regarding new drugs, first identified mephedrone
in 2008. Their research suggests that the drug first became
available to purchase on the internet in 2007. Mephedrone was
first seized in France in May 2007 after police sent a tablet
that they assumed to be ecstasy to be analysed, with the
discovery being discussed in a paper titled "Is
4-methylephedrone, an “Ecstasy” of the twenty first century?"
The drug was used in early products, such as Neodoves pills, by
the legal high company Neorganics, but the range was
discontinued in January 2008 after the government of Israel,
where the company is based, made mephedrone illegal. Mephedrone
was reported as having been sold as ecstasyin the
Australian city of Cairns, along with ethylcathinone in 2008.
Europol noted that they became aware of it in 2008, after it was
found in Denmark, Finland and the UK. The Drug Enforcement
Agency noted it was present in the United States in July 2009.
By May 2010, mephedrone had been detected in every one of the 22
EU member states that reported to Europol, as well as in Croatia
and Norway. It was reportedly manufactured in China, but it has
since been made illegal there. In March 2009, Druglink
magazine reported that it only cost a "couple hundred pounds" to
synthesize a kilogram of mephedrone. The Daily Telegraph
reported that manufacturers were making "huge amounts of money"
from selling the drug. In January 2010 Druglink magazine
reported that dealers in Britain spent £2,500 to ship one
kilogram from China but could sell it for £10 a gram making a
profit of £7,500. A later report, in March 2010, stated that the
wholesale price of mephedrone was £4000 per kilogram.

In the United Kingdom

The number of samples analyzed by the Forensic Science Service
of seized MDMA, piperazines and cathinones between the third
quarter of 2005 and the first quarter of 2010. MDMA seizures in
blue, piperazine seizures in orange and cathinone seizures in
purple

Between the summer
of 2009 and March 2010 the use of mephedrone grew rapidly in the
UK, with it being readily available at music festivals, head
shops and on the internet. A survey of Mixmag readers in
2009, found that it was the fourth most popular street drug in
the United Kingdom, behind cannabis, cocaine,
and ecstasy. The drug is used by a diverse range
of social groups. Whilst the evidence is anecdotal, researchers,
charity workers, teachers and users have reported widespread and
increasing use of the drug. The drug's rapid growth in
popularity was believed to be related to both its availability
and legality. Fiona Measham, a criminologist at The University
of Lancaster, believes that the emergence of mephedrone was also
related to the decreasing purity of ecstasy and cocaine on sale
in the UK, a view reinforced in a report by the National
Treatment Agency for Substance Misuse. The average cocaine
purity fell from 60% in 1999 to 22% in 2009 and about half of
ecstasy pills seized in 2009 contained no MDMA, and by June
2010, almost all pills seized in the UK, contained no MDMA. A
similar pattern was observed in the Netherlands, with the number
of ecstacy tablets containing no MDMA rising from 10% in mid
2008 to 60% by mid 2009 and with mephedrone being detected in
20% of ecstacy tablets by mid 2009. The decrease of MDMA was
thought in part, to be due to the seizure of 33 tonnes of
sassafras oil, the precursor to MDMA, in Cambodia in June 2008,
which could have been used to make 245 million doses of MDMA.
According to John Ramsey, a toxicologist at St George's,
University of London, the emergence of mephedrone was also
related to the UK government banning the benzylpiperazine class
of drugs. Mephedrone was available on at least 31 websites based
in the UK in December 2009; by March 2010 there were at least 78
online shops, half of which sold amounts of less than 200 grams
and half that also sold bulk quantities. The price per gram
varied from £9.50 to £14. Between July 2009 and February 2010,
UK health professionals accessed the National Poisons
Information Service's (NPIS) entry on mephedrone 1664 times and
made 157 telephone inquiries; the requests increased month on
month over this period. In comparison over a similar time
period, the entries for cocaine and MDMA were accessed
approximately 2400 times. After mephedrone was made illegal, the
number of inquiries to the NPIS fell substantially, to only 19
in June 2010.

Media
organizations including the BBC and The Guardian, as well
as a news section in the Annals of Botany (later
corrected), incorrectly reported that mephedrone was commonly
used as a plant fertilizer. In fact sellers of the drug
described it as "plant food" because it was illegal to sell the
compound for human consumption. In late 2009, UK newspapers
began referring to the drug as meow or miaow (sometimes doubled
as meow meow or miaow miaow), a name that was almost unknown on
the street at the time. In November 2009, the tabloid newspaper,
The Sun published a story stating that a man had ripped
off his own scrotum whilst using mephedrone, but this story was
later shown to be an online hoax. Other myths that the media
often repeated during 2010 were that mephedrone had led to the
deaths of over 20 people, that teachers were unable to
confiscate the drug off pupils and that the government was too
slow to ban the drug. The Advisory Council on the Misuse of
Drugs (ACMD) have suggested that the media coverage of the drug
led to increased usage of it.

A survey of 1000
secondary school pupils and university students in Tayside,
conducted in February 2010, found that 20% of them had
previously taken mephedrone. Although at the time it was
available legally over the internet, only 10% of users reported
purchasing it online, with most purchasing it from street
dealers. Of those who had used mephedrone, 97% said that it was
easy or very easy to obtain. Around 50% of users reported at
least one negative effect associated with the use of mephedrone,
with teeth grinding being the most common.

On 30 March 2010,
Alan Johnson, then the Home Secretary, announced that mephedrone
would be made illegal "within weeks" after the ACMD sent him a
report on the use of cathinones. Prior to the ban being
announced, Dr Polly Taylor, a member of the ACMD resigned,
saying she "did not have trust" in the way the government would
use the advice given by the ACMD. Eric Carlin, a member of the
ACMD and former chairman of the English Drug Education Forum,
also resigned after the announcement that mephedrone would be
made illegal. He said that the decision by the Home Secretary
was "unduly based on media and political pressure" and there was
"little or no discussion about how our recommendation to
classify this drug would be likely to impact on young people's
behaviour." Some ex-members of the ACMD, and various charity
groups have expressed concern regarding the banning of the drug,
arguing it will inevitably criminalise users, particularly young
people. Others have expressed concern that the drug will now be
left in the hands of black market dealers, who will only
compound the problem. The ACMD had run into problems with the UK
Government in 2009 regarding drugs policy, after the government
did not follow the advice of the ACMD to reclassify MDMA
and cannabis, culminating in the dismissal of the
ACMD chairman, David Nutt after he reiterated the ACMD's
findings in an academic lecture. Eric Carlin's resignation was
specifically linked to the criminalization of mephedrone, and he
stated: "We need to review our entire approach to drugs, dumping
the idea that legally-sanctioned punishments for drug users
should constitute a main part of the armory in helping to solve
our country’s drug problems. We need to stop harming people who
need help and support". An editorial in the April 2010 edition
of The Lancet questioned the decision to ban mephedrone,
saying that the ACMD did not have enough evidence to judge the
potential harms caused by mephedrone and arguing that policy
makers should have sought to understand why young people took it
and how they can be influenced to not take it. In Chemistry
World, John Mann professor of chemistry at Queen's
University Belfast, suggested that the UK create a law similar
to the Federal Analog Act of the United States, which would have
made mephedrone illegal as an analog of cathinone. In August
2010, James Brokenshire, the Home Office drugs minister,
announced plans to create a new category in the Misuse of Drugs
Act 1971, through the Police Reform and Social Responsibility
Bill, that would allow new legal highs to be made temporarily
illegal, without the need for a vote in parliament or advice
from the ACMD, as was required to categorize mephedrone.

According to the
Independent Scientific Committee on Drugs, since mephedrone was
made illegal a street trade in the drug has emerged, with prices
around double those prior to the ban, at £20-£25 per gram. In
September 2010, Druglink reported that the ban had had a
mixed effect on mephedrone use, with it decreasing in some
areas, remaining similar in others and becoming more prevalent
in some areas. An online survey of 150 users after the ban, 63%
said that they were continuing to use mephedrone, half of those
used the same amount and half said they used less. Compared to
previous surveys, more users purchased it off dealers, rather
than the internet. The average price per gram was £16, compared
to around £10 before the ban. Professor Shiela Bird, a
statistician at the Medical Research Council, has suggested that
the ban of mephedrone may lead to more cocaine related deaths.
In the first 6 months of 2009, the number of cocaine related
deaths fell for the first time in four years, and fewer soldiers
tested positive for cocaine in 2009 than in 2008. She suggested
that this may have been due to users switching to mephedrone
from cocaine, but cautioned that before full figures are
available for 2009 and 2010, it will be difficult to determine
whether mephedrone saved lives, rather than cost them. Other
supposedly legal drugs have filled the gap in the market since
mephedrone was made illegal, including naphyrone (NRG-1) (since
made illegal) and Ivory Wave, which has been found
to contain MDPV, a compound made illegal at the
same time as mephedrone. However it is possible that some
products branded as Ivory Wave do not contain MDPV. When tested,
some products sold six weeks after mephedrone was banned,
advertised as NRG-1, NRG-2 and MDAI were found to be mephedrone.

Effects

There have been no
formal published studies into the effects of mephedrone
psychological and behavioural effects of mephedrone on humans
nor on animals from which the potential effects could be
extrapolated. As a result, the only information available comes
from users themselves and clinical reports of acute mephedrone
toxicity. Psychologists at Liverpool John Moores University were
to conduct research into the effects of mephedrone on up to 50
students already using the drug, when it was still legal in the
UK. At the time the study was proposed, Les Iversen, the chair
of the Advisory Council on the Misuse of Drugs called the
experiments "pretty unethical". The study was discontinued in
August 2010, following the change in the legal status of the
drug.

Intended effects

Users have
reported that mephedrone causes euphoria, stimulation, an
enhanced appreciation for music, an elevated mood, decreased
hostility, improved mental function and mild sexual stimulation;
these effects are similar to the effects of cocaine, amphetamines and MDMA. These effects last different
amounts of time, depending on the way the drug is taken. When
taken orally, users report they can feel the effects within
15–45 minutes, when snorted the effects are felt within minutes
and peak within half an hour. The effects last for between two
and three hours when taken orally or nasally, but only half an
hour if taken intravenously. Out of 70 Dutch users of
mephedrone, 58 described it as an overall pleasant experience
and 12 described it as being an unpleasant experience. A survey
of UK users, who had previously taken cocaine, found that most
users found it produced a better quality and longer lasting
high, was less addictive and carried the same risk as using
cocaine.

Side effects

According to drugs
counselors on Teesside, UK, mephedrone can cause hallucinations,
nausea, vomiting, blood circulation problems, rashes, anxiety,
paranoia, fits and delusions. According to the drugs advice
charity, Crew2000, other side effects may include poor
concentration, poor short-term memory, increased heart rate,
abnormal heart beats, anxiety, depression, increased sweating,
dilated pupils, the inability to normally open the mouth, and
teeth grinding. When snorted it can also cause nose bleeds and
nose burns. A survey conducted by the National Addiction Centre,
UK found that 51% of mephedrone users said they suffered from
headaches, 43% from heart palpitations, 27% from nausea and 15%
from cold or blue fingers, indicative of vasoconstriction
occurring. Doctors at Guy's Hospital, London reported that of 15
patients they treated after taking mephedrone in 2009, 53.3%
were agitated, 40% tachycardic, 20% had systolic hypertension
and 20% had seizures; three required treatment with
benzodiazepines, predominantly to control their agitation. They
reported that none of their patients suffered from cold or blue
peripheries, contrary to other reports. Nine out of the 15 of
patients had a Glasgow Coma Scale (GCS) of 15 indicating that
they were in a normal mental state, 4 had a GCS below 8, but
these patients all reported using a central nervous system
depressant, most commonly GHB, with mephedrone.
The patients also reported polydrug use of a variety of
compounds.

Long-term effects

Almost nothing is
known about the long-term effects of the drug due to the short
history of its use. BBC News reported that one person who
used the drug for 18 months became dependent on the drug, in the
end using it twice a week, had to be admitted to a psychiatric
unit after he started experiencing hallucinations, agitation,
excitability and mania. Because of its similarity to cathinone,
John Mann, has posited that mephedrone may cause impotence with
long-term use.

Typical use and
consumption

Mephedrone can
come in the form of capsules, tablets or white powder that users
may swallow, snort or inject. It is sometimes sold mixed with
methylone in a product called bubbles in the UK and also mixed
with other cathinones including ethcathinone, butylone,
fluoromethcathinone and methedrone. The Guardian reported
that some users compulsively redose, consuming their whole
supply when they are only meant to use a small dose and there
have been other similar reports of users craving mephedrone,
suggesting that it may be addictive. A survey conducted in late
2009 by the National Addiction Centre (UK) found 41.3% of
readers of Mixmag had used mephedrone in the last month,
making it the fourth most popular drug amongst clubbers. Of
those, two thirds snorted the drug and the average dosage per
session was 0.9g; the length of sessions increased as the dosage
increased. Users who snorted the drug reported using more per
session than those who took it orally (0.97 g compared to
0.74 g) and also reported using it more often (5 days per month
compared to 3 days per month). An Irish study of people on a
methadone treatment program for heroin addicts found that 29 out
of 209 patients tested positive for mephedrone usage.

Pharmacology

Very little is
known about the pharmacology of mephedrone. Writing in the
British Medical Journal, psychiatrists stated that given its
chemical structure, "mephedrone is likely to stimulate the
release of, and then inhibit the reuptake of monoamine
neurotransmitters". The cathinone derivatives methcathinone and
methylone, act in a similar way to amphetamines
mainly acting on catecholamine transporters so it is expected
that mephedrone also acts in this way. The actions of
amphetamines and cathinones are determined by the differences in
how they bind to noradrenalin, dopamine and serotonin
transporters. Molecular modeling of mephedrone suggests it is
more hydrophilic than methyl-amphetamines which may account for
the higher doses required to achieve a similar effect, because
mephedrone is less able to cross the blood-brain barrier. Of the
two enantiomers, it is thought that the S form is more
potent than the R form, based on the fact that this
applies to cathinone. Professor David Nutt, former chair of the
Advisory Council on the Misuse of Drugs (ACMD) in the UK has
said "people are better off taking ecstasy or amphetamines than
those [drugs] we know nothing about" and "Who knows what's in
[mephedrone] when you buy it? We don't have a testing system. It
could be very dangerous, we just don't know. These chemicals
have never been put into animals, let alone humans." Les King, a
former member of the ACMD, has stated that mephedrone appears to
be less potent than amphetamine and ecstasy but that any benefit
associated with this could be negated by users taking larger
amounts. He also told the BBC "all we can say is [mephedrone] is
probably as harmful as ecstasy and amphetamines and wait until
we have some better scientific evidence to support that."

Metabolism

Based on the
analysis of rat and human urine by gas chromatography and
mass spectrometry, mephedrone is thought to be
metabolized by three phase I pathways. It can be demethylated to
the primary amine (producing compounds 2, 3 and 4) the ketone
group can be reduced (producing 3) or the tolyl group can be
oxidized (producing 5 and 6). It is thought that 5 and 6 are
further metabolised by conjugation to the glucuronide and
sulfate derivatives. Knowledge of the primary routes of
metabolism should allow the intake of mephedrone to be confirmed
by drug tests, as well as more accurate
determination of the cause of side effects and potential for
toxicity.

Toxicity

As of March 2010,
there have been no reported studies on the potential
neurotoxicity of mephedrone nor is the median lethal dose known.
In 2009, one case of sympathomimetic toxicity was reported in
the UK after a person took 0.2 g of mephedrone orally and 3.8 g
subcutaneously. The patient was treated with 1 mg of lorazepam
and the sympathomimetic features decreased within 6 hours of
treatment. The Swedish medical journal Läkartidningen
reported that mephedrone could theoretically cause the
cardiovascular problems associated with the use of cocaine and
amphetamines and serotonin syndrome associated with the use of
ecstasy and LSD. One case of serotonin syndrome has been
reported, where the patient was already prescribed fluoxetine
and olanzapine and then took 40 tablets containing mephedrone in
one night. He was treated with lorazepam and discharged 15 hours
after admission. Both enantiomers of methcathinone, which
differs only in the lack of the methyl group on the aryl ring
when compared to mephedrone, have been shown to be toxic to rat
dopamine neurons, and the S-enantiomer was also toxic against
serotonin neurons. Simon Gibbons and Mire Zloh of The School of
Pharmacy, University of London stated that based on the chemical
similarities between methcathinone and mephedrone, "it is highly
likely that mephedrone will display neurotoxicity". However,
Brunt and colleagues stated that "extreme caution" should be
used when inferring the toxicity of mephedrone from
methcathinone, noting that some of the toxicity associated with
methcathinone is due to manganese impurities related to its
synthesis, rather than the compound itself. They concluded that
experimental research is needed to investigate the toxicity of
mephedrone. Doctors who treated a 15 year old female suffering
from mephedrone intoxication suggested in The Lancet that
like MDMA, mephedrone may promote serotonin-mediated release of
antidiuretic hormone resulting in hyponatraemia and an altered
mental state. In another case, a 19 year old male was admitted
to hospital suffering from inflammation of the heart, 20 hours
after taking one gram of mephedrone. The doctors treating the
patient stated it was caused by either a direct toxic effect of
mephedrone on the heart muscle, or by an immune response. One
case of acquired methaemoglobinaemia, where a patient had
"bluish lips and fingers", has also been reported, after they
snorted one gram of mephedrone. The patient started to recover
after being hospitalized and it was not necessary to administer
any medication.

Deaths

Sweden

In 2008, an
18-year-old Swedish woman died in Stockholm after taking
mephedrone allegedly in combination with cannabis. Svenska
Dagbladet reported that the woman went into convulsions and
turned blue in the face. Doctors reported that she was comatose
and suffering from hyponatremia and severe hypokalemia; the
woman died one and a half days after the onset of symptoms. An
autopsy showed severe brain swelling. Mephedrone was scheduled
to be classified as a "dangerous substance" in Sweden even
before the girl's death at Karolinska University Hospital on
Sunday, 14 December, but the death brought more media attention
to the drug. The possession of mephedrone became classified as a
criminal offence in Sweden on 15 December 2008.

UK

In 2010, there
were unconfirmed reports speculating about the role mephedrone
has played in the deaths of several young people in the UK. By
July 2010, mephedrone had been alleged to be involved in 52
fatalities in the UK, but detected in only 38 of these cases. Of
the nine that coroners had finished investigating, two were
caused directly by mephedrone. The first death reported to be
caused by mephedrone use was that of 46 year old, Stirling
Smith, who had underlying health problems and repeatedly
injected the drug. A report in Forensic Science International
in August 2010 stated that mephedrone intoxication has been
recorded as the cause of death in two cases in Scotland. Post
mortem samples showed the concentration of mephedrone in their
blood was 22 mg/L in one case and 3.3 mg/L in the other. The
death of a teenager in the UK in November 2009 was widely
reported as being caused by mephedrone, but a report by the
coroner concluded that she died from natural causes. Toxicology
reports following the deaths of two teenagers (Louis Wainwright,
18, and Nicholas Smith, 19) that were widely reported by the
media to be caused by mephedrone, and which led to a ban on the
substance in April 2010, showed that the teenagers had in fact
not taken any mephedrone. According to Fiona Measham, a
criminologist who is a member of the ACMD, the reporting of the
unconfirmed deaths by newspapers followed "the usual cycle of
‘exaggeration, distortion, inaccuracy and sensationalism'"
associated with the reporting of recreational drug use.

USA

Mephedrone has
been implicated in the death of a 22 year old male, who had also
injected black tar heroin. Mephedrone was found in
his blood at a concentration of 0.50 mg/L and in his urine at a
concentration of 198 mg/L. The blood concentration of morphine,
a metabolite of heroin, was 0.06 mg/L. For comparison, the
average blood morphine concentration resulting from deadly
overdoses involving only heroin is around 0.34 mg/L.

Chemistry

Appearance

A sample of mephedrone that was confiscated in Oregon, USA, 2009

Mephedrone is a
white substance. It is sold most commonly as crystals or a
powder, but also in the form of capsules or pills. It can have a
distinctive odor, reported to range from a synthetic fishy smell
to the smell of vanilla and bleach, stale urine, electric
circuit boards.

Legal status

When mephedrone
was rediscovered in 2003, it was not specifically illegal to
possess in any country, as its use has increased many countries
have passed legislation making the possession, sale and
manufacturing of mephedrone illegal. It was first made illegal
in Israel, where it had been found in products such as Neodoves
pills, in January 2008. After the death of a young woman in
Sweden in December 2008 was linked to the use of mephedrone, it
was classified as a hazardous substance a few days later, making
it illegal to sell in Sweden. In June 2009, it was classified as
a narcotic with the possession of 15 grams or more resulting in
a minimum of two years in prison - a longer sentence, gram for
gram than given for the possession of cocaine or heroin. In
December 2008, Denmark also made it illegal and through the
Medicines Act of Finland it was made illegal to possess without
a prescription. In November 2009, it was classified as a
"narcotic or psychotropic" substance and added to the list of
controlled substances in Estonia and made illegal to import into
Guernsey along with other legal highs, before being classified
as a Class B drug in April 2010. It was classified as a Class C
drug in Jersey in December 2009.

In 2010, as its
use became more prevalent, many countries passed legislation
prohibiting mephedrone. It became illegal in Croatia and Germany
in January, followed by Romania and the Isle of Man in February.
In March 2010, it was classified as an unregulated medicine in
the Netherlands, making the sale and distribution of it illegal.
On 30 March 2010, the ACMD in the UK published a report on
mephedrone and recommended it being classified as a Class B
drug. On 7 April 2010 the Misuse of Drugs Act 1971 (Amendment)
Order 2010 was passed by parliament, making mephedrone and other
substituted cathinones Class B drugs from 16 April 2010. Prior
to the ban taking effect, mephedrone was not covered by the
Misuse of Drugs Act 1971. It was however an offence under the
Medicines Act to sell it for human consumption, so it was often
sold as "plant food" or "bath salts" although, as it has no use
as such products, this too was possibly illegal under the Trade
Descriptions Act 1968. The importation of mephedrone into the UK
was banned on 29 March 2010. In May 2010 the Republic of Ireland
made it illegal, followed by Belgium, Italy, Lithuania, France
and Norway in June and Russia in July. In August 2010, Austria
and Poland made mephedrone illegal and China announced that it
would be illegal as of 1 September 2010. Mephedrone had been
reported to be used in Singapore in February 2010, but it was
made illegal in November 2010. In December 2010, following the
advice of the EMCDDA, mephedrone was made illegal throughout the
EU, a move that Switzerland also made shortly afterwards. In
countries, which have not already banned it, such as the
Netherlands, Greece, Spain and Portugal, they will need to
change legislation to comply with the EU ruling. In Hungary, a
government advisory body recommended that mephedrone should made
illegal in August 2010. The recommendation was followed and it
was made illegal in January 2010.

In some countries,
mephedrone is not specifically listed as illegal but is
controlled under legislation that makes compounds illegal if
they are analogs of drugs already listed. In Australia it is not
specifically listed as prohibited, but Federal Police have
stated that it is an analogue to methcathinone and therefore
illegal. In February 2010, 22 men were arrested in conjunction
with importing mephedrone. Similarly in New Zealand it is not
included in the Misuse of Drugs Act 1975, but is illegal as it
is similar to controlled substances. In Canada, mephedrone is
not explicitly listed in any Schedule of the Controlled Drugs
and Substances Act, "amphetamines, their salts, derivatives,
isomers and analogues and salts of derivatives, isomers and
analogues" are included in Section I of Schedule III of the act.
Cathinone and methcathinone are listed in separate sections of
Schedule III while diethylpropion and pyrovalerone (also
cathinones), are listed in separate sections of Schedule IV,
each without language to capture analogues, isomers, etc.
According to The Globe and Mail, mephedrone is considered
a controlled substance by Health Canada. According to the
Canadian Medical Association, mephedrone is grouped with other
amphetamines as Schedule III controlled substances. There have
been several media reports of the Canadian police seizing
mephedrone. Mephedrone is also unscheduled in the United States
but has been made illegal in North Dakota. Those selling the
drug for human consumption may however, be prosecuted under the
Federal Analog Act due to its similarity to methcathinone.